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General NPI Number Information
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NPI Number | 1124147079
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Entity Type | Individual
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Provider Name | GARY C LANGE PHD LMFT LCPC MS LPC
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Gender | Male
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2862 N BELTLINE
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City | SUNNYVALE
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State | TX
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Zip | 75182-9388
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Country | US
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Telephone | 972-698-8478
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Fax | 972-698-8469
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Provider Business Mailing Address
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Address Line | 133 RIDGEGATE DR
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City | GARLAND
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State | TX
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Zip | 75040-3557
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Country | US
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Telephone | 972-530-0871
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Fax | 972-530-0871
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | 75029
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3682
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 759
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License Number State | TX
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